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11.12.2000 | O. Stepanenko, Chortkiv

The sad statistics

   

The tendencies in the health protection in the Ternopil oblast are the same as in Ukraine in general: the rate of diseases is growing, the number of medical establishments and doctors id being reduced. One could agree, after all, with the reduction of the medical staff, because it the actual necessity to optimize the number of the health protection workers, especially in towns and cities. But the reduction as such, without the introduction of the modern methods of organization of treatment, of new methods of prophylaxis, will improve nothing and will not result in a real economy. An unreasonable reduction of the medical staff may result in a further increase of the illness rate among the population. Now the material, financial and informational provision of medicine has fallen below any admissible level. In the rural country no medicine in fact remained. The village inhabitants almost stopped to turn to doctors: they have no money to pay for the most elementary medical drugs, the quality of the medical aid there has worsened. In this connection the official data on oncological diseases, infectious and venereal diseases, leptospirosis and TB-infection (the latter now have reached the level of the 40s-50s) are underrated. The data on the cardiac-vascular maladies are, in my opinion, somewhat overrated, because the reasons of death at home are, as a rule, unknown, and the standard reason is written as ’cardiac’. The birth rate is fast decreasing during the recent three years. All statistical data on the Ternopil oblast given below are compiled by the health protection department of the Ternopil oblast state administration. For comparison the data on Ukraine as a whole are given; these data are taken from the Brief reference book of the state statistical committee of Ukraine ’Ukraine of 1999 in figures’.





Number of TB-cases


Number of oncological diseases


Number of venereal diseases








Syphilis


Gonorrhea
 

Abs.

numb.


For 100 thous.


Abs.

numb.


For 100 thous.


Abs. umb.


For 10 thous.


Abs.Numb


For 10 thous.


Ternopil oblast

3201

27.41

22021

189.21

4171

3.5841

4341

3.731



Totally in Ukraine

27100

54.6

754400

1525

566800

11.5

26100

5.26



1
– data for 9 months of 1999

Birth rate, mortality rate, natality of population (for 1000 of population)

 

1990


1996


1997


1999
 

Terno-pil obl.


Ukraine


Terno-pil obl.


Ukraine


Terno-pil obl.


Ukraine


Terno-pil obl.


Ukraine


Total birth rate


14.2


12.7


11.5


9.1


10.9


8.7


9.6


7.8


Total mortality


12.8


12.1


13.9


15.2


14.3


14.9


14.3


14.8


Natality


1.4


0.6


-2.4


-6.1


-3.4


-6.2


-4.7


-7.0


Mortality of new-born

11.4

12.8

13.3

14.3

12.5

14.0

13.3

12.8



The analysis of these data leads to pessimistic conclusions. It is good the bulletin ’Prava ludyny’ touched the topic of the right for medical aid. I agree with I. Sukhorukova that ’the society treats the problem with an inadmissible flippancy’. I reckon that the government position in the questions of medical aid may be characterized as amoral and even criminal: the financing is lower than any reasonable minimum, there is no strategy at all of leading the branch out of the collapse, even serious discussions are not held. It seems that the authorities have taken off responsibility for the lot of unhealthy people, in fact are proposed to die quietly. The former Soviet system of health protection may certainly be criticized, yet no one can affirm that there was no system: it was imperfect, but actually working. The motto ’Pay, if you want to survive’ could be put now on the facades of today’s hospitals.

The medical public organizations ’The pulse of Ukraine’, that was created during the election campaign by ex-minister Raisa Bogatyriova, turned to Ukrainian MPs with the request to hand the application to the Constitutional Court concerning the interpretation of a somewhat vague Article 49 of the Ukrainian Constitution about the free medical aid. As such, this application may be sensible: there must exist an official interpretation of this article. As to me, the very text of this article must be changed to become more concrete. The most important meaning, which can be read between the lines of this appeal, is the conviction (and obedient consent) that no budget money will be given for medicine by the authorities! So, the load of financing on the medical reform is suggested to put on tax-payers’ shoulders, and the medical part of the public does not object.

Yet, if someone proposes me to sign this appeal, I will do it to make the medical problems to be at last publicly discussed in the Parliament. I agree with the creation of the joint funds for financing, I am for the development of medical insurance. Yet, I believe that one must be a complete idealist to hope that all this will start working rather soon, thus supporting the drowning system of health protection. Nobody else, but our very modest in such affairs state, must take the main part of expenses for the financial, material, personnel, informational, etc. provision of the necessary minimum of the free medical aid. This minimum must be officially delimited, be financed from the state budget and be guaranteed to everybody – from the President to a hobo. All the rest must be paid from the municipal, insurance and private financing. It is obvious that the state will give money for the provision of this more or less accessible minimum only under the condition, if the society, public and Church demand it.

So this problem must be permanently stirred up to acquire any decent priority. It must be also done on ’Prava ludyny’ pages.

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